Expanding the reach of cancer genetic services to underserved Spanish-speaking Latina women

University Of Utah, Salt Lake City UT

Investigators

Linked publications & trials

Abstract

PROJECT ABSTRACT This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-OD- 22-208” as a supplement to the Huntsman Cancer Institute (HCI) Cancer Center Support Grant (5P30CA042014-33). The proposed project would directly address Strategic Goal 3.1 from the 2019-2023 Trans-NIH Strategic Plan for Women’s Health Research, Advancing Science for the Health of Women: Design and test approaches to promote the adoption, adaptation, and integration of evidence-based interventions in public health, clinical practice, and community settings. The project would also address areas of emphasis in NOT-OD-22-208, including studies seeking to identify novel dissemination and implementation approaches to reach underserved, understudied, and underrepresented populations of women. In prior work, we implemented a standards-based software platform coupled with algorithms that identify patients who meet criteria for cancer genetic testing based on family history data. In the Broadening the Reach, Impact, and Delivery of Genetic Services trial (U01CA232826), we are comparing uptake of genetic testing for an automated tool (i.e., chatbot) vs. standard of care cancer genetic services delivery models for 1300 patients identified by the algorithm. Our prior work has identified substantial disparities in the presence and comprehensiveness of cancer family history data in the electronic health record, leading to under-identification of Spanish-speaking and Latinx patients by the algorithm. Preliminary data are also indicating lower uptake of the Spanish language chatbot in our current trial. Combined with prior data showing lower utilization of cancer genetic services among Latinx patients, it is critical to adapt approaches to better reach Spanish-speaking Latina women. Our team has utilized the mobile HCI Cancer Screening and Education Bus to conduct family history screening with Spanish- speaking Latina women, and has found substantial interest in cancer genetic counseling and testing in this community. We therefore propose two Supplemental Specific Aims. Aim 1 will utilize a multi-method ethnographic workflow analysis to characterize intervention points to utilize automated tools to identify Spanish-speaking Latina women eligible for cancer genetic evaluation and offer genetic services. Aim 2 will utilize community engagement and user-centered design methods to investigate the cultural and linguistic suitability of automated tools created in our prior work and test the feasibility of using culturally tailored automated tools with this community. The proposed project relates directly to an aim of the HCI Cancer Center Support Grant: to effectively and compassionately address the needs of our service area through state-wide alliances, community-based services, and impactful research, with a focus on areas of high cancer incidence and mortality in Utah, as well as health disparities. The project also aligns with HCI’s goal to lead the translation of cancer genetic services to the population, including underserved populations.